Androgen Replacement Therapy of Male Hypogonadism

Abstract

Male hypogonadism is a relatively common disorder in clinical practice and has significant effects on the fertility, sexual function and general health of patients (1–8). Disorders of sperm and testosterone production may be caused by primary, secondary, or tertiary hypogonadism. Some are relatively common and others are rare. Klinefelter’ s syndrome is a primary testicular disorder occurring in about 1 in 500 men and resulting in both androgen deficiency and infertility (9–11). In men with clinical manifestations of primary or secondary hypogonadism, deficiency of testosterone usually can be treated effectively. Fertility in some men with primary testicular disease, such as Klinefelter’ s syndrome, is irreversible, but those with gonadotropin deficiency resulting in infertility can often be treated successfully (12–14). Both testosterone deficiency and infertility can be corrected using gonadotropin or gonadotropin-releasing hormone (GnRH) therapy in men with hypogonadotropic hypogonadism. Understanding the pathophysiology of hypogonadism is needed to plan and use appropriate hormonal replacement therapy in men with deficiency of testosterone and sperm production.